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Consulting to
the public sector provides special challenges. Demographic
and economic factors combine to produce important changes
in social infrastructure. The major components of this infrastructure
- health care institutions, social service programs, and schools,
colleges and universities - have become established means
of investing in the future. This investment, however, has
significant operating cost implications. Health,
social services and education consume
the major portion of public expenditures in Canada and similar
levels in other developed countries. Understanding these three
program areas and developing necessary and appropriate policies,
planning systems and capital development plans present an
enormous challenge to those responsible for funding, managing
and providing services.
RMC and
its members are experienced in working with government and
with such public sector enterprises as hospitals, social service
centres, colleges and universities. This public sector work
is counterpoint to our private sector consulting for large
and small industrial clients. In this way we are able to evolve
concepts that are transferable between the private and public
sectors. However, while many planning and management techniques
are transferable, they must be carefully evaluated in the
context of the special sensitivities that exist for governments,
institutional governing boards, program advisory committees
and the wide range of professionals who both serve the public
and administer programs in health, social services and education.
The backgrounds
of RMC's professional staff reflect our experience in diverse
fields such as population control and community health; health
services administration and delivery; care of the elderly;
family support and income maintenance; post-secondary education
administration and delivery; and capital development for all
sectors ranging from strategic/master planning to architecture.
These backgrounds are complemented by the capabilities of
our colleagues in the corporate planning, information systems,
human resources, and productivity improvement parts of our
practice. For more information on our work with health authorities
and hospitals, please refer to the next section titled Our
Work in Facility Planning.
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Health
and Social Services
Members
of RMC have been involved, both nationally and internationally,
in health and social services projects as diverse as countrywide
comprehensive health care restructuring; the establishment
of regional health authorities; the development of management
planning and control systems and specialty studies for individual
institutions; and assisting clients to manage complex technical
and capital works projects.
Typical
Assignments
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RMC was
awarded a WB Health Workforce and Services project in
Indonesia to assist the MOH, Ministry of National Education
and Indonesia Medical Association and the provinces in
their joint effort to improve their institutional capacity
for human resources policy and planning in accordance
with the current and future health care needs of the population
(2002).
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As part of
the $134 million IDB funded Health Sector Reform Programme,
RMC was retained by the MOH of Trinidad & Tobago to
assist the Project Administration Unit in the selection
of appropriate consultants, the evaluation of their work
and the administration of their contracts involving some
100 technical assistance projects encompassing:
- Reform
of the Ministry of Health
- Devolution
of Service Delivery to RHA
- PHC Development,
Promotion & Training
- Rationalizing
of Health Service Delivery
- Development
of a Comprehensive Financing System and, in the process,
transfer such knowledge, skills and systems to the MOH
and RHAs.
Also acting
as advisors to the Minister and senior Ministry officials
on policy issues arising from the health care restructuring,
as well as to undertake, on a sole-source basis, a number
of the consultancies: the most significant over the recent
past, include (1999-2005):
- The development
of a National Emergency Medical Services (NEMS) policy
and operational framework for Trinidad & Tobago (T&T)
including: situation analysis; medical direction; integration
into hospital services; scope and funding; human resources/training;
quality management; MIS; preventive maintenance; and community/public
information. Also prepared a Tender Document to effect
outsourcing of day-to-day management NEMS capable to provide
advice and guidance to RHAs to operate a NEMS in their
respective regions (2001-2002).
- National
Health Insurance. Provided advice to the MoH regarding
health financing/cost recovery as a prelude to the introduction
of a National Health Insurance scheme. Organized two seminars
with internationally recognized experts as speakers, attended
by major stakeholders (2002).
- Pharmaceutical
Services. Assessed the strength and weaknesses provided
by the private and public sectors throughout T&T and
provided advice and assistance in the design of chronic
disease drug program for the population 65+ and the disabled
including monitoring assistance during programme implementation
(Phase I); Developed a National Pharmaceutical services
plan including products to be available (public/private);
National Drug Formulary (content and administration);
procurement, storage and distribution; financial implications,
projected budgets and funding options; policy, legislation,
human resources, organization systems; implementation
time-frame (Phase 2) (2002-2003).
- National
Needs Assessment (NNA). The overall objective of the project
was to facilitate the development of NNA capacity in the
MoH of T&T and in so doing to enable the RHAs to assess
health care needs, prioritize the needs and interventions
in the most efficient and effective manner. Also to train
and build capacity within the RHAs to be able to carry
out NNA in the future and to incorporate NNA as part of
their annual regional health care plans (2003-2004).
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Retained
to provide financial management and procurement advisory
services to the Albania Ministry of Health, PCU on a USD17
million W.B. funded Health Systems Recovery and Development
Project to rationalize and strengthen the governance structure
and management capacity at the national and regional levels
and to improve the effectiveness and quality of health
service delivery in the Tirana Region (1999-2001).
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RMC
was commissioned by the Alberta Provincial Health &
Wellness Department to revise the 1995 Health Needs Assessment
Guide so that it is "user friendly" and incorporates
new information, approaches and language, e.g. Accountability
Framework, Expectations and Measures; Health Authority
Business Plan and Annual Requirements; Health Trends;
RHA Health Needs Assessment Review and Expectations. RMC
worked with a committee from seven of the RHAs and the
Ministry. The revised guide incorporates key planning
information from the RHAs, e.g. their successes, anecdotal
information, etc., and reference material. (2001)
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Guyana
Health Sector Policy and Institutional Development Program
funded by IADB. The 20 month project, with 63 person-months
of professional level of effort dealt with health policy;
legal and regulatory issues; health economics/financing;
financial management/ MIS; health planning/epidemiology;
public health/PHC; health services management; human resource
development and management; hospital administration; quality
assurance; health education and promotion. (1999-2000).
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Secondment
of a Senior Principal for a one-year period to be the
Director of the Program Management Office (PMO) of a Smart
Systems for Health project of the Ontario Ministry of
Health. The objectives of the PMO was to design infrastructure
to deliver Smart System products and services; establish
standards and policy for the future use of technology;
recommend governance, financing and security policies;
coordinate efforts of health sector and technology partners;
and raise health policy issues for determination by the
Ministry of Health. About 80 professionals, including
three from RMC, were involved during the course of the
project.
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Development
and execution of a three-day conference in Budapest, Hungary
entitled Hospital Based Management Information Systems
- The Canadian Experience under the auspices of the World
Bank, the Canadian and Ontario Governments and attended
by senior Ministry of Health officials from Central and
Eastern Europe, the Baltic Republics and former Soviet
states.
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Conducted
a needs assessment study that dealt with identifying continuing/long
term care directions in the Lloydminster Health District
(Saskatchewan). The study entailed: developing population
and long term care bed forecasts; researched trends in
long term care delivery; interviewed key stakeholders;
conducted focus group with area residents; and developed
program alternatives.
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Retained
by the WestView Regional Health Authority (Alberta) to
conduct a regional health needs assessment. The study
work plan included: an analysis of demographic and health
status information; stakeholder and community input through
the use of stake-holder work sessions, community focus
groups and a telephone survey of 600 residents; the identification
and validation of health needs.
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RMC
assisted the WestView Health Region to develop terms of
reference for private partnerships in the design and operation
of continuing care beds in the Hinton and Evansburg communities.
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Review
of continuing care programs for Palliser Health Authority
(Alberta). The study included: review of current programs
and services; key stakeholder consultation and site visits;
focus groups with continuing care users and their family
caregivers; research regarding program innovations in
continuing care; a population and bed forecast projection
for the region; and development of program options.
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As
part of a consortium retained by the Hungarian Ministry
of Welfare, World Bank PMU on a Heart Healthy Nutrition
Project, RMC's role was to provide assistance in project
management, and health promotion.
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Provided
financial management and procurement advisory services
to the Georgia MOH, PCU on a World Bank funded project
dealing with health systems, human resources, health financing
and rehabilitation of health facilities.
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RMC,
in partnership with Cambridge Consulting Corporation,
provided to the Belize MOH and Sports, advisory services
to the Health Policy Reform Project. The objective is
to increase the ability of the MOH to identify, design,
implement and evaluate strategies and policies to improve
efficiency, equity and quality of the Belizean health
care system.
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During
the 1990's RMC organized and conducted Fellowship Programs
for Ministers of Health and their senior officials from
Estonia, Georgia, Lithuania, Poland, Slovenia and Ukraine,
introducing them to the Canadian experience in health
care restructuring.
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Retained
by the Armenia Ministry of Health to provide advisory
services dealing with primary health care as a forerunner
to a World Bank funded project.
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RMC
continues to work in health reform in Canada for Regional/District
Health Authorities in Western Canada. Typical areas of
involvement include determining health needs, trends and
service requirements; identifying strategic options; recommending
distribution of beds, service programs and location; evaluating
the existing facilities, capacity for providing required
services; and providing architectural block schematics
for the purpose of planning and cost projections.
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Assisted
the Poland MOH in managing a US$135 million World Bank
funded project (1994-1996). During 1992-93 RMC provided
advisory services to the MOH in policy formulation and
strategic planning and the development of a work program
for the introduction of a national health insurance. On
the WB assignment emphasis was on: health promotion, primary
health care, health management training and education,
pharmaceutical monitoring, MIS/IT, and physical evaluation
of hospitals.
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Assisted
the Estonian Minister of Social Affairs in managing a
W.B. funded health sector project, including assistance
in accounting, administration and procurement; development
of course material for training of local architects in
the design of health architects in the design of health
facilities; and physical planning and cost estimation
of a new Biomedical and Health Sciences Complex.
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RMC
provided advisory services to the Lithuanian Minister
of Health and senior Ministry officials in policy formulation;
health legislation; primary health care; health financing/cost
recovery; organizational issues; management development/manpower
planning; and other advisory services necessary for the
development of an effective health care delivery.
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Retained
by Turkey MOH, Health Reform Project, to review proposed
universal health insurance scheme, resulting in recommendations
to modify the process and content of the Project.
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For
the Slovenia Ministry of Health, RMC introduced Ministry
officials to organization structures, management concepts
and systems and procedures for health care delivery and
assisted officials to identify those that would best serve
Slovenian needs.
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Assisted
the Uganda Ministry of Health to prepare for the Second
World Bank Health Project. In addition to studies in institutional
strengthening, decentralization, information systems and
NGO/private-sector AIDS programming, RMC also completed
a detailed feasibility study of relocating the Ministry
of Health Headquarters from Entebbe to Kampala.
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RMC
assessed the health care sector and type and nature of
health care delivery in Belarus and Ukraine as part of
the World Bank team.
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In
the Bahamas, RMC was involved in restructuring and institutional
strengthening of the MOH. The work included policy formulation,
planning and programming; formulation of health legislation;
organization and managerial reforms; design and implementation
of cost accounting and management information system;
development and implementation of a supply management
system and maintenance program.
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Reviewed
emergency services in 10 hospitals for the B.C. Ministry
of Health, addressing such issues as categories and functions;
referrals and regional and district control; ambulance
diversion and the availability of emergency and ICU beds
in comparison to the anticipated level of requirement;
and underlying problems and factors contributing to the
present status.
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For
the Mental Health Services Branch of the Saskatchewan
Government, RMC completed a strategic study of long-term
psychiatric care including development of values, principles
and delivery system functions for guiding future planning.
A key issue was the future of one remaining long-term
psychiatric care hospital in the province and the viability
of deinstitutionalizing its residents by providing their
care from a community base rather than from a single centralized
provincial facility.
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Studied
strategic options for Environmental Health in Alberta
to establish a framework for organizing environmental
health programming among government departments and local
health units. Reviewed health promotion methods, risk
determination methods and epidemiological data to establish
an agenda of health issues requiring priority attention
by the government. The study developed definition of and
responsibilities in environmental health for Alberta Health
and its local health units.
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Directed
and jointly conducted a review of cancer services in Ontario
with Coopers & Lybrand. The study examined respective
mandates of Ontario Cancer Treatment and Research Foundation
and Ontario Cancer Institute; examined and evaluated alternative
options for their organizations; recommended changes i.e.,
programs, manpower, equipment and space; addressed cost
implications; and proposed merging 2 organizations into
a single provincial agency, resulting in a $200 million
funding program by the government of Ontario.
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On
behalf of Canadian International Develop-ment Agency,
completed a multi-year family planning project in Bangladesh.
Project included monitoring and improving procurement
and distribution of 18million cycles of oral contraceptives;
researched acceptance and effects.
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Conducted
an organization study of the 452-bed Dr. Everett Chalmers
Hospital in Fredericton, New Brunswick; a similar study
was also conducted for the 207-bed Glenrose Rehabilitation
Hospital in Edmonton, Alberta.
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On
behalf of Alberta Social Service and Community Health,
RMC reviewed the Coordinated Home Care Program in Alberta
and evaluated its performance after 4 years of operations.
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On
behalf of Health and Welfare Canada, studied present and
potential alcohol/drug problems in Northwest Territories
and developed a strategic plan to provide effective, community-based
prevention and treatment services.
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On
behalf of the government of Newfoundland, conducted a
study of health care delivery in the Central Region; including
a major review of 10 hospitals and development of strategic
plan defining their new role. Undertook a similar study
for Inuvik Region of NWT.
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Assessed
health facility requirements in 2 health delivery sectors
for Metro-Edmonton District 106 and examined options to
meet perceived needs. Study team visited model health
service and health maintenance organizations in Ontario
and the United States.
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On
behalf of the government of Alberta, con-ducted a feasibility
study to establish the scope, anticipated costs and implications
of developing a computer-based planning model capability
to facilitate predesign planning of health care facilities,
including needs analysis, definition of project scope
and functional planning.
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Completed
a comprehensive study of health care delivery in the Yukon
Territory for Health and Welfare Canada. Study included
needs assessment, operating system, planning requirements,
and financial implications; also a master development
plan for the Whitehorse General Hospital.
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RMC
worked on a number of assignments over a 3-year period
on behalf of the Alberta Children's Provincial Hospital
(ACPH) and the Foothills Provincial General Hospital,
including an examination of patient care, diagnostic services,
human resources and medical/nursing education.
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For
the Alberta Workers' Compensation Board Rehabilitation
Centre, RMC completed operational review and a strategic
management plan including development of mandate and objectives
in area of rehabilitation, including service delivery
model and implementation strategy.
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Conducted
study for Corrections Canada to determine the requirements
for a Regional Health Centre to serve the needs of all
Pacific Region (B.C.) correctional institutions and its
potential viability with the Regional Psychiatric Centre.
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RMC
offered advisory and executive search services to the
University of Colorado to staff King Khalid Hospital,
an 800-bed acute care facility, in Riyadh, Saudi Arabia.
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Developed
strategic plan for delivery of geriatric and rehabilitation
services for residents of Yukon Territory.
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On
behalf of the N.W.T. Registered Nurses Association, RMC
assessed future role of nursing within context of changes
in the Canadian health care system and emerging issues
in health care services for women in the Northwest Territories.
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Formulated
a policy on palliative care for Alberta Hospitals and
Medical Care, to serve as planning framework for the establishment
of programs throughout Alberta.
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Education
Universities
and community colleges, which are called upon to develop
programs and capital facilities that will respond to community
and regional needs, are faced with competing and conflicting
demands. RMC, with a multi-disciplinary staff and experience
in planning post-secondary institutions, undertaking feasibility
studies and organization and operations reviews, is well-suited
to assist agencies responsible for providing education.
Typical
Assignments
- Southern
Alberta Institute of Technology (SAIT) Aero Centre
Functional Program for the proposed development of a new
SAIT Aero Centre for Training and Technology. The purpose
of the functional program was to identify the programmatic
and spatial requirements of the Aero Centre for Training
and Technology. (2002)
- Keyano
College, MacKenzie Campus Development Study (2002) to address
both short term priorities and longer term requirements.
The study assessed existing and potential utilization, examined
limitations of existing facilities and infrastructure and
opportunities to enhance viability of the campus, identified
options for facility use and development and recommended
capital developments to accommodate the proposed changes.
Other projects for Keyano College included: Technology Centre
Functional Prograrmme (2001), and; Sports and Wellness Centre,
Programme Concept (2002).
- University
of Alberta, National Research Council of Canada, National
Institute for NanoTechnology (NINT), Detailed Space Programme
(2002). RMC identified the programmatic, functional and
space requirements for the proposed NINT facility, as a
basis for the architectural and engineering design of the
building. (2002)
- University
of Alberta and National Research Council,
National Institute for Nanotechnology, Functional Programme.
The space programme identified the programme and space requirements
and related functional and technical criteria to accommodate
the NRC both for the interim period and plan the space for
long term use by UofA. The space programme provided the
basis for the architectural and engineering design of the
facility. (2001)
- University
of Alberta, National Resources Engineering Facility (NREF),
Detailed Space programme. RMC, in partnership with The Cohos
Evamy Partners, prepared the detailed space programme for
the Department of Civil and Environmental Engineering. RMC
identified the programme and space requirements for a new
building for the NREF to accommodate the research, instructional
and administrative functions of the Department. Documentation
was prepared in accordance with U of A standards to provide
the information necessary for the subsequent stages of design
(2001).
- For
Grant MacEwan Community College in Edmonton, Alberta, provided
strategic planning services including identifying intermediate
and long-term facility needs to support the changing client
base and the new delivery systems required in the market
area, also examined consequences arising from various development
options.
- For
the Alberta College in Edmonton reviewed all business education
programs with emphasis on training using new technologies,
including development of future directions relevant to employment
opportunities and the needs of the business community.
- Alberta
Advanced Education & Career Development anticipates
that some 25,000 new additional students will have to be
accommodated by the year 2005. RMC was commissioned to determine
the accommodation capability (capacity) of the existing
post-secondary educational facilities. The study determined
that the most valid and consistent indicator of capacity
is classroom space availability and utilization. Using several
utilization factors, the study arrived at accommodation
capability in the range or 109,000 to 128,000, with the
lower end being close to the existing enrolment in the system
and the higher range capable of handling the expected enrollment
to the year 2005.
- Conducted
a strategic study for Northern Alberta Development Council
on adult education and training needs. The study examined
the existing system and its delivery capability; future
needs; and models required to deliver the required services
within the context of major hydrocarbon and forestry developments
in Northern Alberta.
- Prepared
a strategic plan for Thebacha College in Fort Smith, Northwest
Territories, with satellite facilities in 5 other NWT communities.
This became a study of post-secondary education throughout
the territories including the review of the educational
programs and operations; an assessment of needs generated
by normal growth and hydrocarbon-industry-induced growth
in context of socio-economic factors; facility evaluation;
and identification of issues and service gaps.
- Provided
advisory services in campus development to the University
of Calgary in preparation of detailed functional programs
for 3 major capital projects connected with the 1988 Winter
Olympics.
- For
the Alberta Ethnic Language Teachers' Association, RMC conducted
a feasibility study and prepared a strategic plan for multilingual
centres. The study assessed the need for multilingual centres
in Edmonton and Calgary, determined commitment of existing
heritage schools to a new multi-lingual centre, determined
availability of suitable facilities, designed an administrative
structure, and developed pro forma operating budgets.
- For
the Lakeland College, completed 5 separate projects that
included: a long-range plan and Strategy for Growth; operational
budget reviews; functional programming of a major building
renovation; detailed energy conservation analysis of the
entire Vermilion campus; and planning and programming for
the new $40 million campus for 850 students in Lloydminster,
Alberta.
- Developed
system of rating degree of urgency of proposed capital and
maintenance projects. The system was customized to requirements
of the University of Alberta and includes a number of factors
ranging from health and safety concerns to anticipated program
changes. It is being used to rate projects of all sizes
and produces an objective prioritized list which can be
used to justify funding requests.
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